瞳孔緊張症
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/06/21 15:30:34」(JST)
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Adie's syndrome |
Classification and external resources |
Two-sided dilated pupils given the observational diagnosis Adie's pupils by an ophthalmologist |
ICD-10 |
H57.0 |
ICD-9 |
379.46 |
DiseasesDB |
29742 |
MeSH |
D015845 |
Adie syndrome, sometimes known as Holmes-Adie Syndrome or Adie's Tonic Pupil, is a neurological disorder characterized by a tonically dilated pupil.[1] It is named after the British neurologist William John Adie. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and affects the pupil of the eye and the autonomic nervous system. [1]
Contents
- 1 Signs and symptoms
- 2 Pathophysiology
- 3 Diagnosis
- 4 Treatment
- 5 Prognosis
- 6 Epidemiology
- 7 See also
- 8 References
- 9 External links
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Signs and symptoms[edit]
Adie syndrome presents with three hallmark symptoms, namely at least one abnormally dilated pupil (mydriasis) which does not constrict in response to light, loss of deep tendon reflexes, and abnormalities of sweating.[1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.[2]
Pathophysiology[edit]
Pupillary symptoms of Holmes-Adie Syndrome are thought to be the result of a viral or bacterial infection that causes inflammation and damage to neurons in the ciliary ganglion, an area of the brain that provides parasympathetic control of eye constriction. Additionally, patients with Holmes-Adie Syndrome can also experience problems with autonomic control of the body. This second set of symptoms is caused by damage to the dorsal root ganglia of the spinal cord.[1]
Diagnosis[edit]
Clinical exam may reveal sectoral paresis of the iris sphincter or vermiform iris movements. The tonic pupil may become smaller (miotic) over time which is referred to as "little old Adie's".[3] Testing with low dose (1/8%) pilocarpine may constrict the tonic pupil due to cholinergic denervation supersensitivity.[1] A normal pupil will not constrict with the dilute dose of pilocarpine.[3] CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.[4]
Treatment[edit]
The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s).[1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure.[1] Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.[1]
Prognosis[edit]
Adie's syndrome is not life threatening or disabling.[1] As such, there is no mortality rate relating to the condition; however, loss of deep tendon reflexes is permanent and may progress over time.[1]
Epidemiology[edit]
It most commonly affects younger women (2.6:1 female preponderance) and is unilateral in 80% of cases.[3] Average age of onset is 32 years.
See also[edit]
- Ross’ syndrome
- Ciliary ganglion
References[edit]
- ^ a b c d e f g h i j National Institute of Neurological Disorders and Stroke. "Holmes-Adie syndrome Information Page". Retrieved 2008-01-21.
- ^ Stedman's Medical Dictionary, 27th Edition. 2000. ISBN 0-683-40007-X.
- ^ a b c Haines, Duane E. (2002). Fundamental Neuroscience, 2nd edition. ISBN 0-443-06603-5.
- ^ "Diagnosis of Adie syndrome". WrongDiagnosis.com. Retrieved 2008-01-21.
External links[edit]
- Personal experience
- Animation at mrcophth.com
English Journal
- Brief Report: Evidence for Normative Resting-State Physiology in Autism.
- Nuske HJ1, Vivanti G, Dissanayake C.Author information 1Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, VIC, 3086, Australia, h.nuske@latrobe.edu.au.AbstractAlthough the conception of autism as a disorder of abnormal resting-state physiology has a long history, the evidence remains mixed. Using state-of-the-art eye-tracking pupillometry, resting-state (tonic) pupil size was measured in children with and without autism. No group differences in tonic pupil size were found, and tonic pupil size was not related to age or cognitive ability in either group, and nor was it related to autistic symptoms. We suggest that previous findings of hyper-arousal in autism at baseline may be a product of different recording methods, in particular different movement-artifact removal techniques. These results question the notion that autism is associated with a fundamental dysregulation in resting-state physiology. Further research, employing such techniques is needed to confirm these findings.
- Journal of autism and developmental disorders.J Autism Dev Disord.2014 Feb 19. [Epub ahead of print]
- Although the conception of autism as a disorder of abnormal resting-state physiology has a long history, the evidence remains mixed. Using state-of-the-art eye-tracking pupillometry, resting-state (tonic) pupil size was measured in children with and without autism. No group differences in tonic pupi
- PMID 24550080
- Your eyes give you away: prestimulus changes in pupil diameter correlate with poststimulus task-related EEG dynamics.
- Hong L, Walz JM, Sajda P.Author information Department of Biomedical Engineering, Columbia University, New York, New York, United States of America.AbstractPupillary measures have been linked to arousal and attention as well as activity in the brainstem's locus coeruleus norepinephrine (LC-NE) system. Similarly, there is evidence that evoked EEG responses, such as the P3, might have LC-NE activity as their basis. Since it is not feasible to record electrophysiological data directly from the LC in humans due to its location in the brainstem, an open question has been whether pupillary measures and EEG variability can be linked in a meaningful way to shed light on the nature of the LC-NE role in attention and arousal. We used an auditory oddball task with a data-driven approach to learn task-relevant projections of the EEG, for windows of data spanning the entire trial. We investigated linear and quadratic relationships between the evoked EEG along these projections and both prestimulus (baseline) and poststimulus (evoked dilation) pupil diameter measurements. We found that baseline pupil diameter correlates with early (175-200 ms) and late (350-400 ms) EEG component variability, suggesting a linear relationship between baseline (tonic) LC-NE activity and evoked EEG. We found no relationships between evoked EEG and evoked pupil dilation, which is often associated with evoked (phasic) LC activity. After regressing out reaction time (RT), the correlation between EEG variability and baseline pupil diameter remained, suggesting that such correlation is not explainable by RT variability. We also investigated the relationship between these pupil measures and prestimulus EEG alpha activity, which has been reported as a marker of attentional state, and found a negative linear relationship with evoked pupil dilation. In summary, our results demonstrate significant relationships between prestimulus and poststimulus neural and pupillary measures, and they provide further evidence for tight coupling between attentional state and evoked neural activity and for the role of cortical and subcortical networks underlying the process of target detection.
- PloS one.PLoS One.2014 Mar 11;9(3):e91321. doi: 10.1371/journal.pone.0091321. eCollection 2014.
- Pupillary measures have been linked to arousal and attention as well as activity in the brainstem's locus coeruleus norepinephrine (LC-NE) system. Similarly, there is evidence that evoked EEG responses, such as the P3, might have LC-NE activity as their basis. Since it is not feasible to record elec
- PMID 24618591
- Tonic pupil, anterior ischemic optic neuropathy in a teenager with Takayasu arteritis.
- Matalia J1, Kasturi N, Anaspure HD, Shetty BK.
- Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.Can J Ophthalmol.2013 Dec;48(6):e159-63. doi: 10.1016/j.jcjo.2013.07.005.
- PMID 24314433
Japanese Journal
- Pupillotoniaについて (第11回神経眼科研究会)
- 川辺 敏
- 千葉医学会雑誌 35(5), 2297-2306, 1960-01
- … Pupillotonia developing in patients in Japan involved the eye of one side as in patients abroad; …
- NAID 110007346046
Related Links
- Pupillotonia information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues. ... Introduction: Pupillotonia Description of Pupillotonia Pupillotonia: A pupillary abnormality characterized ...
- Learn about Pupillotonia from patients' first hand experiences and trusted online health resources, including common treatments and medications. 172 discussions on Treato ... About Treato ×
Related Pictures
★リンクテーブル★
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- 英
- tonic pupil
- ラ
- pupillotonia
- 同
- 偽アーガイル・ロバートソン瞳孔 pseudo-Argyll Robertson pupil、強直性瞳孔 pupillotonia、筋強直性瞳孔 myotonic pupil、散大性瞳孔強直 mydriatic rigidity
- 関
- 緊張性瞳孔